Miscarriage
What is Miscarriage?
Miscarriage is the loss of a pregnancy before the 20th week. Most miscarriages happen in the first 13 weeks of pregnancy. This experience affects about 10 to 20 percent of known pregnancies.
Miscarriage is often caused by chromosomal problems in the developing embryo. These genetic issues happen randomly and are not usually inherited. Other causes include hormone imbalances, uterine problems, infections, and certain health conditions.
While miscarriage can be emotionally difficult, most people who experience one go on to have healthy pregnancies later. Understanding your risk factors and hormone levels can help you prepare for a healthy pregnancy. Testing hormone levels like progesterone can provide insight into pregnancy health.
Symptoms
Many miscarriages happen before a person even knows they are pregnant. When symptoms do occur, they may include:
- Vaginal bleeding or spotting that may be light or heavy
- Cramping or pain in the lower abdomen or back
- Fluid or tissue passing from the vagina
- Sudden decrease in pregnancy symptoms like nausea or breast tenderness
- Loss of fetal heartbeat detected during ultrasound
Some spotting in early pregnancy is common and does not always mean miscarriage. However, any bleeding during pregnancy should be evaluated by a healthcare provider.
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Causes and risk factors
Most miscarriages are caused by chromosomal abnormalities that prevent the embryo from developing properly. These genetic problems usually happen by chance during cell division. Other causes include hormone imbalances, particularly low progesterone levels that cannot support a growing pregnancy. Uterine structural problems, thyroid disorders, uncontrolled diabetes, and autoimmune conditions can also increase risk.
Risk factors include advanced maternal age, particularly over 35 years old. Previous miscarriages increase the likelihood of future losses. Smoking, alcohol use, drug use, and excessive caffeine intake raise risk. Certain infections, exposure to environmental toxins, and being significantly underweight or overweight can also contribute. Most miscarriages cannot be prevented, but addressing modifiable risk factors may help.
How it's diagnosed
Miscarriage is typically diagnosed through a combination of physical exam, ultrasound, and blood tests. An ultrasound can show whether a fetal heartbeat is present and if the pregnancy is developing normally. Blood tests measure hormone levels, particularly human chorionic gonadotropin, which should rise steadily in early pregnancy.
Progesterone testing is valuable for assessing pregnancy health and miscarriage risk. Low progesterone levels may indicate a pregnancy that is not viable or at higher risk. Rite Aid offers progesterone testing as an add-on to help you understand your hormone levels. Testing before and during early pregnancy can provide important information about your reproductive health.
Treatment options
Treatment options depend on whether the miscarriage is complete, incomplete, or threatened. Treatment approaches include:
- Expectant management, allowing the body to pass the tissue naturally over several days to weeks
- Medication to help the uterus expel pregnancy tissue more quickly
- Surgical procedure called dilation and curettage to remove remaining tissue
- Progesterone supplementation in some cases to support early pregnancy if levels are low
- Emotional support and counseling to process grief and loss
- Rest and pain management with over-the-counter medications as recommended by your doctor
- Follow-up blood tests to ensure pregnancy hormone levels return to normal
- Evaluation for underlying causes after two or more consecutive miscarriages
Most healthcare providers recommend waiting for one normal menstrual cycle before trying to conceive again. However, this timeline may vary based on individual circumstances.
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Frequently asked questions
The most common signs include vaginal bleeding or spotting and cramping in the lower abdomen or back. You may also pass fluid or tissue from the vagina. Some people notice a sudden decrease in pregnancy symptoms like nausea or breast tenderness. Any bleeding during pregnancy should be evaluated by a healthcare provider right away.
Yes, low progesterone levels can contribute to miscarriage risk. Progesterone helps prepare and maintain the uterine lining to support a developing pregnancy. When levels are too low, the uterus may not be able to sustain the pregnancy. Testing progesterone levels before and during early pregnancy can help identify potential issues.
Progesterone testing is most useful during the second half of your menstrual cycle or in early pregnancy. If you have a history of miscarriage or difficulty conceiving, testing can help identify hormone imbalances. Your healthcare provider may also recommend testing if you experience spotting or symptoms that suggest low progesterone. Rite Aid offers progesterone testing as an add-on to our health panel.
Miscarriage affects about 10 to 20 percent of known pregnancies. Most miscarriages occur in the first 13 weeks of pregnancy. The actual rate may be higher because many miscarriages happen before a person realizes they are pregnant. Risk increases with maternal age, particularly after age 35.
Most miscarriages are caused by chromosomal abnormalities in the developing embryo. These genetic problems usually happen randomly during cell division and are not inherited. Other causes include hormone imbalances, uterine problems, infections, and certain health conditions. In many cases, the exact cause cannot be determined.
Most miscarriages cannot be prevented because they are caused by random chromosomal problems. However, you can reduce risk by maintaining a healthy weight, avoiding smoking and alcohol, limiting caffeine, and managing chronic conditions like diabetes. Taking prenatal vitamins with folic acid before conception may also help. Talk to your doctor about your individual risk factors.
Most healthcare providers recommend waiting for one normal menstrual cycle before trying to conceive again. This allows your body to heal physically and helps with accurate pregnancy dating. However, recent research suggests there is no medical reason to wait longer unless complications occurred. Emotional readiness is also important, so take the time you need.
Most people who experience one miscarriage go on to have healthy pregnancies later. The risk of recurrent miscarriage is relatively low after a single loss. However, risk increases slightly after two miscarriages and more significantly after three. Your healthcare provider may recommend testing for underlying causes after two or more consecutive losses.
A threatened miscarriage means you have vaginal bleeding and possibly cramping, but the pregnancy is still viable. The cervix remains closed and ultrasound shows a fetal heartbeat. About half of threatened miscarriages continue to healthy pregnancies. Your doctor may recommend rest, progesterone supplementation if levels are low, and follow-up monitoring.
Treatment depends on whether the miscarriage is complete or if tissue remains in the uterus. You may choose expectant management, allowing your body to pass the tissue naturally. Medication can help speed the process, or a minor surgical procedure can remove remaining tissue. Your doctor will recommend follow-up blood tests to ensure pregnancy hormone levels return to normal.